This invention generally relates to emergency medical instruments and more specifically to oral and pharyngeal suction devices which are used to remove vomitus, blood and foreign material from the mouths and pharynges of patients during cardiopulmonary resuscitation or trauma stabilization.
Suction devices of various designs are used during many medical procedures. The devices generally utilize a vacuum source, a collection container, and associated tubing. More specifically, a vacuum is effected within the collection container by means of the vacuum source. One end of a flexible connecting tube is connected to the collection container and the other end of the tube is attached to a suction tip which is used to remove debris and fluids from cavities in the patient's body.
During cardiac arrest the victim's stomach contents may be regurgitated and fill the hypopharyngeal, oropharyngeal, nasopharyngeal, and oral cavities. This may occur spontaneously or during resuscitative efforts when repeated tracheo-esophageal insufflation causes reflex emptying of an over distended stomach. If the victim has recently eaten, as is frequently the case, the vomitus emptied from the stomach contains large pieces of poorly chewed and undigested food 1/2 inch in diameter or larger. Before effective resuscitation can be accomplished, the victim's throat must be cleared of foreign matter and an open airway established.
In such situations the end of the suction device must be inserted into the patient's mouth and oro/hypopharynges in order to remove vomitus from the area of the epiglottis, glottis and hypopharyngeal sphincter. All of the above mentioned tissues are delicate and easily injured.
Prior suction devices are sometimes provided with a tube or wand located at the end of the suction hose to allow the open end of the tubing to be inserted into the field of operation, or through the oropharyngeal cavity. Present designs of such devices suffer at least three shortcomings.
First, the vacuum delivered to the end of the tubing or wand must be rather substantial to enable the extraction of debris and vomitus. However, this causes a dangerous condition in that in some circumstances the end can easily come into contact with healthy but delicate tissues, i.e. organs in the oropharyngeal and hypopharyngeal cavity. The suction causes the edges of the tube or wand to be drawn into the tissue surface while the tissues themselves are partially drawn into the inner bore of the wand, causing "vacuum injuries".
Typical kinds of attempts to avoid such conditions may be seen in U.S. Pat. No. 3,848,604, to Sackner; U.S. Pat. No. 3,945,385, to Sackner; U.S. Pat. No. 4,022,218, to Riddick; and U.S. Pat. No. 4,221,220, to Hansen. In all such examples the wand or tube is provided with a number of holes around its perimeter at a location adjacent to the influent end. Such holes prevent a full vacuum from being developed at the influent end of the wand even if the end is inadvertently blocked by tissue. However, this compromises the ability of the device to create full suction under normal conditions. Further, the peripheral holes are relatively small and thus can become clogged with debris. Once clogged, the aforementioned safety effect of the peripheral holes is defeated and the possibility of damage to the tissues increases.
The second type of attempt to avoid damage due to vacuum injuries can be seen in U.S. Pat. No. 3,321,087, to Fuge and Garber, although it is specifically designed for harvesting allantoic fluid. A similar design approach is used in the construction of the aspirator commonly used by dentists. In each case the end of the suction device is provided with a structure having a multiplicity of small, uniform perforations. These perforations tend to prevent damage to tissue since it is unlikely that they would all be entirely covered by a tissue surface at the same time. However, because of their small size, large pieces of debris cannot be removed through the suction device. These devices are designed to act as strainers and cannot be used to clear the vomitus, and particularly, large chunks of food or clotted blood. Even small pieces of debris can clog the perforations and render those suction devices inoperative.
Second, all the above mentioned devices use tubing and wands of relatively small inner diameter and inner passages. This makes them unsuitable for cleaning the oro and hypopharynges during cardiopulmonary resuscitation or trauma stabilization since the inner passages will become clogged by large pieces of vomitus and debris.
Third, few of the devices in the prior art are compatible with vacuum and collection systems designed for other suction devices. This makes it necessary for hospitals to purchase and maintain a special system for each type of suction device.
In conclusion, all of the devices in the prior art have serious shortcomings and are especially unsuited for use during cardiopulmonary resuscitation.
Thus it is an object of the present invention to provide a suction device especially suited for clearing the oro and hypopharynges during cardiopulmonary resuscitation or trauma stabilization.
It is a further object of the present invention to provide a suction device which will not damage even delicate tissues in the area of use, but which will remove semi-solid and solid material of relatively large size.
It is a further object of the present invention to provide a suction device which resists clogging.
It is another object of the present invention to provide a suction device utilizing a wand which may be used with or without a locking tip guard, depending on the trauma involved and the size of the debris to be removed.
It is still another object of the present invention to provide a suction device having a tip which can be selectively oriented before being locked in place.
It is another object of the present invention to provide a suction device which provides a means for visually orienting the device into a preferred position for insertion into the oropharyngeal cavity.
It is another object of the present invention to provide a suction device which may be used with a variety of vacuum and collection apparatus.